We come full circle in our latest Pathology Spotlight blog as we revisit the heart, the organ in question from our first pathology spotlight.
Coarctation is an example of a congenital (present at birth) condition. The narrowing of the aorta by the coarctation deprives the lower body of the full flow of blood. Also, because of the narrowing, the heart has to work harder to pump blood through the narrowed section and so blood- pressure can rise in those arteries upstream of the narrowing (e.g. the arms) but the pressure can be low in downstream arteries (e.g. the legs). The wall of the left ventricle of the heart can increase in thickness because of the extra work that it has to do to work against the narrowed aorta.
The heart has been partly dissected to show the chambers. It also shows the aorta with 3 large vessels arising from the arch of the aorta at the top, which supply blood to the upper body and the head. The coarctation is seen as an abnormal fold (arrow) which, like a kink in a hose, has considerably narrowed the calibre of the aorta (star). It is evident that the flow of blood beyond the coarctation, to the lower body, must be severely reduced
Coarctation affects around 3 or 4 per 10,000 live births and it is amongst the more common of the congenital heart abnormalities. Surgical treatment involves cutting out the narrowed section and sewing the healthy ends of the aorta together to restore the normal calibre of the vessel. Coarctation may be diagnosed on ultrasound scan in pregnancy or in the first year of life by the presence of a heart murmur, high blood pressure in the arms, and absent or diminished pulse in the arteries supplying the legs.